Micronutrient status in children aged 6-59 months with severe wasting and/or nutritional edema: implications for nutritional rehabilitation formulations

Laura Vresk; Mary Flanagan; Allison I Daniel; Isabel Potani; Celine Bourdon; Carolyn Spiegel-Feld; Mehakpreet K Thind; Amber Farooqui; Catriona Ling; Emiliano Miraglia; Guanlan Hu; Bijun Wen; Stanley Zlotkin; Philip James; Marie McGrath; Robert H J Bandsma

doi:10.1093/nutrit/nuad165

Micronutrient status in children aged 6-59 months with severe wasting and/or nutritional edema: implications for nutritional rehabilitation formulations

Nutr Rev. 2024 Feb 13:nuad165. doi: 10.1093/nutrit/nuad165. Online ahead of print.

Authors

Laura Vresk¹, Mary Flanagan¹, Allison I Daniel^{1

2}, Isabel Potani¹, Celine Bourdon¹, Carolyn Spiegel-Feld¹, Mehakpreet K Thind¹, Amber Farooqui¹, Catriona Ling¹, Emiliano Miraglia¹, Guanlan Hu¹, Bijun Wen¹, Stanley Zlotkin², Philip James³, Marie McGrath³, Robert H J Bandsma^{1

2}

Affiliations

¹ Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Emergency Nutrition Network, Oxford, United Kingdom.

PMID: 38350491
DOI: 10.1093/nutrit/nuad165

Abstract

Undernutrition remains a global struggle and is associated with almost 45% of deaths in children younger than 5 years. Despite advances in management of severe wasting (though less so for nutritional edema), full and sustained recovery remains elusive. Children with severe wasting and/or nutritional edema (also commonly referred to as severe acute malnutrition and part of the umbrella term "severe malnutrition") continue to have a high mortality rate. This suggests a likely multifactorial etiology that may include micronutrient deficiency. Micronutrients are currently provided in therapeutic foods at levels based on expert opinion, with few supportive studies of high quality having been conducted. This narrative review looks at the knowledge base on micronutrient deficiencies in children aged 6-59 months who have severe wasting and/or nutritional edema, in addition to highlighting areas where further research is warranted (See "Future Directions" section).

Keywords: Severe malnutrition; biotin; calcium; copper; folic acid; iodine; iron; kwashiorkor; magnesium; marasmus; micronutrient deficiency; micronutrient status; micronutrient toxicity; niacin; nutritional edema; pantothenic acid; pediatric; phosphorus; potassium; riboflavin; selenium; severe acute malnutrition; severe wasting; sodium; therapeutic feeds; thiamine; vitamin B12; vitamin B6; zinc.